(a) Except with respect to automobile insurance, all
claim forms for insurance, and all applications for commercial insurance and accident and
health insurance, provided to any person residing or located in this State in connection
with insurance policies for issuance or issuance for delivery in this State, shall
contain the following statement:

"Any person who knowingly and with intent to
defraud any insurance company or other person files an application for insurance or
statement of claim containing any materially false information, or conceals for the
purpose of misleading, information concerning any fact material thereto, commits a
fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty
not to exceed five thousand dollars and the stated value of the claim for each such
violation."

(b) All applications and claim forms for automobile
insurance provided to any person residing or located in this State in connection with
insurance policies for issuance or issuance for delivery in this State shall
contain the following statement:

"Any person who knowingly and with intent to
defraud any insurance company or other person files an application for commercial
insurance or a statement of claim for any commercial or personal insurance benefits
containing any materially false information, or conceals for the purpose of misleading,
information concerning any fact material thereto, and any person who, in connection with
such application or claim, knowingly makes or knowingly assists, abets, solicits or
conspires with another to make a false report of the theft, destruction, damage or
conversion of any motor vehicle to a law enforcement agency, the department of motor
vehicles or an insurance company commits a fraudulent insurance act, which is a crime, and
shall also be subject to a civil penalty not to exceed five thousand dollars and the value
of the subject motor vehicle or stated claim for each violation."

(Emphasis added.)

For further information one may contact Senior
Attorney Susan A. Dess, at the New York City Office.